Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
8 results
Search Results
Item It’s normal to drink, isn’t it? a qualitative study on factors influencing adolescent drinking in Sri Lanka(Sri Lanka Medical Association, 2021) Athauda, L.K.; Pereis-John, R.; McCool, J.; Ameratunga, S.; Wickremasinghe, A.R.Introduction and Objectives In Sri Lanka, adolescent drinking behaviour has been linked to parental, family influence as well as culture and living location. While proximal level social determinants play an important part in influencing adolescent drinking, determinants operating at the distal level have not been discussed adequately. This study aimed to describe the factors influencing adolescent drinking among school going adolescents in the Colombo District. Methods Focus Group Discussions (FGD) were conducted separately for males and females in selected Public Health Midwife (PHM) areas in the Colombo District. A semi structured interview guide facilitated the discussion. Transcripts were translated, transcribed and managed on NVivo 12. Inductive thematic analysis was used to interpret the ideas expressed in the FGDs. Results Fifty adolescents (24 females and 26 males) aged between 16-17 years participated in eight FGDSs. The findings elaborate one overarching theme: it’s normal to drink, isn’t it? Media, culture and society contributed towards building social norms around adolescent drinking. Based on the perception of normalcy around drinking, adolescents were inclined to test their limits and experiment with alcohol, while being influenced by peers. However, they also experienced some restraints, in terms of law, family and culture, which made them question the normalcy around drinking. Conclusion Adolescents engage in social learning, through their distal environment which creates norms and aspirations. Peer engagement facilitates social capital which also contributes towards their decisions to drink. Distal level social determinants are important contributory factors of adolescent alcohol use. Restrictions within this environment may restrict their drinkingItem Promotion of tobacco and alcohol on social media: a mixed methods analysis(Sri Lanka Medical Association, 2021) Athauda, L.K.; Jayawardhane, R.; Chandrasekara, B.E.; Kumari, M.I.P.; Perera, K.M.N.; Rajasuriya, M.Introduction and Objectives Promotion of tobacco and alcohol on the internet is banned in Sri Lanka by the NATA Act. However, it appears that tobacco and alcohol related content are rampant on various social media. This study aimed to describe the portrayal of tobacco and alcohol on Facebook and YouTube in 2019 and 2020. Methods YouTube Videos and Facebook posts were analysed by two independent researchers using a pre-defined data extraction sheet. One-minute interval method was used to analyse content regarding actual or implied use, paraphernalia, brand names, dialogue or text. A 16 member- panel provided qualitative interpretations of selected posts and videos. Results A total of 24 YouTube videos and 240 Facebook posts were studied within 2019 and 2020. On YouTube, within 39 oneminute intervals 69 tobacco scenes were reported while 166 alcohol scenes were reported within 87 one-minute intervals for both years. Within the 240 Facebook posts, tobacco content appeared 252 times and alcohol content appeared 204 times. Majority of tobacco content was actual or implied use while the majority of alcohol content focused on brand names or paraphernalia. The messages delivered on both platforms were interpreted as tobacco and alcohol being fun, normal, sophisticated and a part of modern lifestyle. Conclusion This study finds that social media is used as a vehicle to promote tobacco and alcohol among its users. Frequent and positive portrayal leads to creating norms. Such portrayal is not only a violation of the current legal restrictions, but also creates a harmful environment for young people who engage with social media.Item Usablity of a prototype mobile application for patient record keeping in the ward setting at the National Cancer Insitutite, Sri Lanka (NCISL)(Sri Lanka Medical Association, 2019) Deduwela, R.S.; Siribaddana, P.A.; Marasinghe, R.B.; Siriwardena, N.; Athauda, L.K.INTRODUCTION & OBJECTIVES: Applications of information technology have transformed health care workflow settings globally and locally. Authors designed a patient data capturing tool in the form of a mobile application, to be used in the ward setting at the National Cancer Institute of Sri Lanka, based on the requirements and expectations of medical officers. This study aimed at evaluating the usability of the mobile application. METHODS: A high-fidelity prototype of the mobile application was evaluated for usability with a three-part self-administered questionnaire, given to fifteen randomly selected medical officers in the ward setting. The size was determined by the literature on usability evaluations. It included the System Usability Scale® (SUS), demographics and other usability parameters. Data was analysed on Microsoft Excel and the SUS scale was analysed on author instructions. RESULTS: Of the 15 participants, seven were male, and eight were female. All aged between 30-40 years and all had more than four years of work experience. The prototype received an average SUS score of 68.3 within a range of 47.5 and 92.5. Application received SUS score of >70 (highest category in acceptability range) by eight participants. Among other usability parameters, legibility, user-friendliness, accuracy and relevance of the contents scored the highest. Features that need to be improved such as speed and error recovery were also identified. CONCLUSION: Usability evaluation provided a valuable feedback on the strengths and weaknesses of the mobile application's design. As suggested by results, new mobile application is predicted to serve its purpose, with further modifications applied to the final release.Item Exposure to alcohol marketing among adolescents in Colombo district: A mixed methods study(Sri Lanka Medical Association., 2019) Athauda, L.K.; Wickremasinghe, A.R.; Peiris- John, R.INTRODUCTION & OBJECTIVES: Alcohol initiation age is reported as 14 years in Sri Lanka. Despite regulations to control alcohol marketing, it is accessible, affordable and advertised to adolescents. This study aimed to describe the exposure to alcohol marketing environment among 16 to 18-year old in the Colombo District. METHODS: Eight focus group discussions (5 males,3 female) were conducted with 4-10 participants in each and an online pilot survey among 48 adolescents (16-18 years). The mixed methods approach assessed exposure to alcohol marketing, drinking behaviours and perceptions about alcohol related policy. Focus group transcripts were analysed using NVivo 12 and the survey data was analysed using SPSS 22. RESULTS: Of the males (54.2%, n=26) and females (45.8%, n=22) who participated, 26.5% had drunk alcohol at least once. International school attendees (37.5%, n=18) who consumed alcohol at least once (61 0/0) were higher than the proportion of their government school peers (6%). The minimum age of initiation of drinking was 12 to 13 years. Adolescents identified alcohol drinking as "normal" and found it "affordable"(43.7%) and "accessible"(80%). Adolescents have been exposed to alcohol marketing on social media, mass media, at sports events or restaurants/pubs. Alcohol related content was being shared heavily on social media among those who use it, while adolescents with lower alcohol access experimented with alcohol and other related substances at every opportunity despite their awareness of consequences and regulations. CONCLUSION: Adolescents consider drinking a normal phenomenon which is translated to them through their environment. Their drinking behaviours are fuelled by easy access and affordability despite the current control policies.Item Factors influencing alcohol use among adolescents in South Asia: A Systematic review(Piscataway, NJ, 2020) Athauda, L.K.; Peiris-John, R.; Ameratunga, S.; McCool, J.; Wickremasinghe, R.OBJECTIVE: Alcohol is the leading cause of disability-adjusted life years among 15- to 19-year-olds globally; yet, social and structural determinants of alcohol use among adolescents in low- and middle-income countries are largely unknown. Given that a quarter of the global adolescent population lives in South Asia, this systematic review aims to identify factors influencing alcohol use among 10- to 19-year-olds living in South Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). METHOD: We systematically searched eight databases (SCOPUS, MEDLINE, EMBASE, CINAHL Plus, Cochrane Library, PsycINFO, AMED, EBSCO Host), gray literature, and relevant websites for studies reporting influences at psycho-individual, family, school, peer, neighborhood, or country levels. QATSDD (Quality Assessment Tool for Studies with Diverse Designs) was used for quality assessment. The study protocol was registered with PROSPERO (CRD42017084773). RESULTS: Twenty-three studies were eligible for inclusion. Male gender, age greater than 14 years, depression, religious belief, parental/family members' drinking, reduced parental attention, peer-drinking/pressure/approval, and urban neighborhood were associated with increased risks of adolescent drinking. No information was available from Afghanistan, Bhutan, Bangladesh, Pakistan, and Maldives. There is little evidence available on the determinants at a national (legislature, industry, and media), school, and personality level. CONCLUSIONS: The distal determinants of alcohol use among adolescents living in South Asia are largely unknown. As adolescent drinking behaviors change in response to social media and industry influence, more evidence is needed to reflect the South Asia context.Item Traditional beliefs and practices during the puerperium(Sri Lanka Medical Association, 2012) Athauda, L.K.; Basnayake, R.; Gunawardena, M.; lyshwarya, M.V.; Deduwela, R.S.; Mendis, U.R.R.; Lakmuthu, W.S.D.; Siriwardhana, A.A.R.Y.; Nadeesha, M.G.; Ranga, M.P.; Disnani, H.K.T.; Fernando, S.INTRODUCTION: Descriptive qualitative study was carried out to identify knowledge, attitudes and practices of women based on traditional beliefs during puerperium. Aims: To describe beliefs and practices by women during the puerperium, on hygiene, sexual practices & contraception, physical activity and food taboos. METHODS: Qualitative descriptive study was conducted among Sinhalese, Buddhist women to identify beliefs and practices during puerperium following a normal vaginal delivery. Females admitted at CSTH during the months of September - December 2009 were selected. Three focus group discussions were conducted among women aged 25- 35 years, 45 - 55 years, over 65 years using a focus group study guide. RESULTS: Women abstained from bathing up to 1 month post delivery, to avoid clotting of breast milk. Substitute for bathing is fermentation of back, abdomen & breast with leaves. Water for bath is heated with sunlight for disinfection. Breast feeding is postponed until mother's hair dries completely after a bath. Clothes are disinfected by fumigation with herbs. Cloth straps worn around waist strengthen the abdominal muscles. Episiotomy care involves sitting in a warm salt-water tub, avoiding use of soap and fumigating the site with herbal fumes. Sexual abstinence is practiced for one to three months post partum. Strenuous activity and squatting is avoided in the peuperium. Major food taboos include coconut milk, oil, green leaves, saltwater fish, and pineapple and ana-malu banana. CONCLUSIONS: Families y pressurize younger females to conform with these practices. Older women consider these beliefs and practices as traditional. The basis of these beliefs and practices need further exploration.Item Negative health effects of coconut-are they real at the population level?(Sri Lanka Medical Assosiation, 2012) Athauda, L.K.; Kumarendran, B.; Kasturiratne, A.; Wickremasinghe, A.R.INTRODUCTION: An ecological correlation study was carried out to assess the validity of incriminations on the effects of consumption of coconut products on deaths due to cardiovascular diseases (CVD) Aims: The aim was to evaluate the impact of consumption of coconut products on CVD death rates. Methods: Data from 1961 to 2006 were abstracted from different sources; coconut consumption from the FAO database, CVD deaths from reports of the Department of Census and Statistics, population data from the UN databases and per capita GDP from the World Bank database. Correlational and Regression analyses were carried out. RESULTS: From 1961 to 2006, the average consumption of coconut including copra was 66.19 kg/capita/year, the average consumption of energy was 271.47 kcal/ capita/ day and the average fat supply was 24.46 g/capita/ day. There was no increase in the per capita consumption of coconut products from 1961 to 2006 in Sri Lanka (range 54.1-76.2 kg/capita/year]. The CVD death rates and the proportionate mortality rate due to CVD have increased from 1961 to 2006. Consumption of coconut products was correlated with CVD death rates but no lags seen. CVD death rates were significantly associated with per capita GDP and percentage of urban population but not consumption of coconut products after adjusting for the other variables (R2=0.865J. CONCLUSIONS: Mortality due to cardiovascular diseases was significantly correlated with per capita GDP and percentage of urban population after controlling for other variables. The results do not provide any evidence that consumption of coconut products increases mortality due to cardiovascular diseases at the population level.Item Three-wheeler drivers in Wattala urban council: does earning power depend on involvement with the commercial sex trade?(Sri lanka Medical Association, 2015) Gunawardane, M.A.P.S.; Ganga, W.D.K.; Gunathilake, G.S.N.; Gunasekera, L.N.U.; Gunathilake, U.P.U.G.R.P.; Athauda, L.K.INTRODUCTION _AND OBJECTIVES: National STD/AIDS programme estimated 3000 persons to be living with HIV/AIDS in Sri Lanka in 2009. Three wheeler drivers have been identified to be vulnerable for contracting HIV/AIDS due to close associations with the commercial sex trade. The main objective of this study was to assess the knowledge regarding HIV among three wheeler drivers in Wattala Urban Councif. METHOD: A descriptive cross sectional study was conducted among 350 three-wheeler drivers using a self-administered questionnaire. A score from 0-21 was given to respondents on their knowledge of HIV/AIDS. Correlation analysis was conducted. Results: Mean age of the study group was 33.45 + 9.31 years. A score of 3-4 (total 21) was obtained by 48.6% of respondents. 75 % of the respondents whose score was >10 were involved sexual relations or transportation of Commercial Sex Workers (CSW). 48% drivers were involved in transportation of CSWs, and 12.8% transported and provided their vehicle for CSW activities. 24% admitted to having sexual relationships with CSWs. Drivers earning Rs. 1500/- or more per day were 49.4 %, out of which 51.1% of drivers were involved in the commercial sex trade. Daily income was significantly associated with involvement with commercial sex trade. (r= 0.154, p=0.004). Respondents gained knowledge on HIV/AIDS by television/radio (74.5%), print media (48%) and internet (25.4%). CONCLUSION: Awareness of HIV/AIDS of the study group was at a low level. Majority of three wheeler drivers with a higher income did so by their involvement in the commercial sex trade.